AED Pad Placement: A Complete Guide to Proper Application

Sudden cardiac arrest can strike without warning, turning an ordinary moment into a life-or-death emergency. In these situations, an Automated External Defibrillator, commonly known as an AED, can be the difference between survival and tragedy. AEDs are designed to be used by everyday people, not just medical professionals, but their effectiveness depends heavily on correct use. One of the most critical elements is proper AED pad placement. When pads are applied correctly, the electrical shock can travel through the heart in a way that restores a normal rhythm. When placed incorrectly, the shock may be less effective or delayed. This guide will walk you through everything you need to know about AED pad placement, why it matters, and how hands-on training can build the confidence needed to act fast. If you want to move beyond theory and truly be prepared, learning hands-on AED techniques at CPR Kansas City is an essential next step.

What is an AED and How Does It Work?

An Automated External Defibrillator is a portable device that analyzes the heart’s rhythm and determines whether an electrical shock is needed. During sudden cardiac arrest, the heart often enters a chaotic rhythm such as ventricular fibrillation, which prevents it from pumping blood effectively. The AED delivers a controlled shock that can interrupt this abnormal rhythm and give the heart a chance to reset to a normal beat. While the AED does the analyzing and decision-making, pad placement plays a vital role in guiding the electrical current through the heart muscle. Proper positioning ensures the shock travels across the heart in the most effective pathway, increasing the chances of successful defibrillation and survival.

What is the Correct Approach for AED Pad Placement?

The correct approach to AED pad placement begins with understanding the standard method most people will use. For adults, the most common technique is the anterior-lateral position. This means one pad is placed on the upper right side of the chest, just below the collarbone, while the other pad is placed on the left side of the chest, below the armpit. Before applying the pads, it is important to prepare the chest properly. Clothing should be removed to expose bare skin, and the chest should be dry. Excessive chest hair may need to be quickly shaved using the razor included in many AED kits to ensure good contact. AED pads include clear visual guides printed directly on them, making it easier for rescuers to place them correctly, even under stress.

Where Exactly Are AED Pads Placed?

Knowing exactly where AED pads are placed can help reduce hesitation during an emergency. For standard adult pad placement, the first pad goes on the victim’s upper right chest, above the nipple, and to the right of the sternum. The second pad goes on the lower left side of the chest, a few inches below the armpit. In some situations, an alternative anterior-posterior placement may be used. This involves placing one pad on the front of the chest and the other on the back, between the shoulder blades. This method is often used when the chest is very small, when pads might touch in the standard position, or when a medical device, such as a pacemaker, interferes with normal placement. Understanding these variations is an important part of comprehensive AED training.

Special considerations can arise that make pad placement more challenging. If the person has a medication patch on their chest, it should be removed and the area wiped before placing the pad. If the victim is wet, such as after a water-related incident, the chest should be dried quickly. For individuals with implanted devices, pads should be placed at least an inch away from any visible lump under the skin. While these details matter, it is equally important to remember that doing something is better than doing nothing.

What if the AED Pad Placement is Wrong?

Many people worry about what happens if the AED pad placement is not perfect. The good news is that AEDs are designed to analyze the heart rhythm regardless of pad position, as long as there is reasonable contact with the chest. If pads are placed incorrectly, the device will still assess whether a shock is needed. In some cases, the AED may prompt you to check or reposition the pads. This is why it is important not to let fear of making a mistake delay action. Perfect placement is ideal, but rapid response saves lives. Speed and willingness to act often matter more than flawless technique.

Common AED pad placement mistakes include placing pads too close together, forgetting to remove clothing, or placing pads over metal jewelry or medical patches. These errors can usually be avoided by following the diagrams on the pads and listening carefully to the AED’s voice prompts. Taking a few seconds to expose and prepare the chest properly can prevent delays later. Training reinforces these habits so they become second nature under pressure.

Step-by-Step Guide: Using an AED with Proper Pad Placement

An Automated External Defibrillator (AED) is a life-saving device used during sudden cardiac arrest. Here’s how to use one effectively:

Before You Begin

• Ensure scene safety: – Make sure the area is safe for you and the victim
• Call emergency services: (911 or your local emergency number) immediately
• Start CPR: if you’re trained, while someone retrieves the AED

Step-by-Step Instructions

1. Turn on the AED: Open the device or press the power button. The AED will provide voice prompts to guide you through each step.
2. Expose the chest: Remove or cut away clothing to bare the person’s chest. The chest must be dry – quickly wipe away any water or sweat.
3. Apply the pads correctly: Most AEDs come with two pads that have diagrams showing placement:

• First pad: Place on the upper right side of the chest, just below the collarbone
• Second pad: Place on the lower left side of the chest, below and to the left of the nipple (along the side of the ribcage)

The pads should be placed directly on bare skin with good adhesion.

4. Special considerations for pad placement

• If the person has a pacemaker or implanted defibrillator (you’ll see a small lump under the skin), place pads at least one inch away from the device
• For individuals with excessive chest hair, firmly press down the pads. If they don’t adhere well, quickly shave the area if a razor is in the AED kit, or use a second set of pads to remove hair
• For small children or infants, use pediatric pads if available, or place adult pads on the front and back of the chest rather than front only

5. Let the AED analyze: Once pads are attached, don’t touch the person. The AED will automatically analyze the heart rhythm. Make sure no one is touching the victim during this time.
6. Deliver shock if advised: If the AED determines a shock is needed, it will tell you to press the shock button. Before doing so, loudly state “Clear!” and visually verify no one is touching the person. Then press the button.
7. Continue CPR: After the shock is delivered (or if no shock is advised), immediately resume CPR, starting with chest compressions. The AED will prompt you when to pause for another analysis, typically after two minutes.
8. Follow AED prompts: Continue following the AED’s instructions until emergency medical services arrive or the person begins to breathe normally.

Key Reminders

• Don’t remove the pads once applied – leave them on until emergency personnel arrive
• AEDs are designed to be safe and won’t deliver a shock unless needed
• Every minute counts – begin the process as quickly as possible
• Don’t be afraid to use an AED – you cannot harm someone by using one

Using an AED significantly increases survival chances during cardiac arrest. Taking an AED and CPR training course can help you feel more confident in an emergency.

FAQs about AED Pad Placement

1. Can AED pads be placed over a pacemaker or implanted device?

No, AED pads should never be placed directly over pacemakers, implantable cardioverter-defibrillators (ICDs), or medication patches. These devices typically create a visible bulge under the skin, often in the upper chest area. Place the pad at least one inch away from any implanted device to ensure the electrical current flows properly through the heart. If you notice a bulge or scar, simply adjust the pad position while maintaining the correct overall placement pattern.

2. What should I do if the person has a hairy chest?

If chest hair interferes with proper pad adhesion, act quickly but effectively. Most AED kits include a spare set of pads or a disposable razor for this situation. If the pads don’t stick due to excessive hair, use the first set to quickly remove hair by pressing firmly and ripping them off, then apply the fresh set. Don’t waste valuable time shaving—every second counts during cardiac arrest. The priority is ensuring solid skin contact for effective shock delivery.

3. Is AED pad placement different for children versus adults?

Yes, for children under 8 years old or weighing less than 55 pounds, use pediatric pads if available and follow anterior-posterior placement: one pad on the center of the chest and one on the back between the shoulder blades. This prevents the pads from touching a small body. For adults and older children, use standard adult pads in the anterior-lateral position: upper right chest below the collarbone and lower left side below the armpit. If only adult pads are available for a child, use them—delivering a shock is better than doing nothing.

Conclusion and Call to Action

Proper AED pad placement is a critical skill that can save lives during cardiac emergencies. By understanding the correct positioning for different age groups, recognizing special circumstances like implanted devices or wet environments, and practicing these techniques regularly, you’ll be prepared to act decisively when seconds count. Remember that using an AED incorrectly is still better than not using one at all—these devices are designed with safety features and voice prompts to guide you through the process.

Ready to gain hands-on experience and confidence in using AEDs and performing life-saving techniques? CPR Kansas City offers comprehensive, stress-free training that goes beyond just reading about emergency response. Our American Heart Association-certified courses provide real-world practice with AEDs, CPR, and first aid in a supportive learning environment.

Whether you need CPR certification in Kansas City for your healthcare career or want to be prepared for emergencies in your workplace or community, our expert instructors will ensure you master these critical skills. We offer BLS classes in Kansas City along with ACLS, PALS, and CPR and First Aid certifications—all with initial and renewal options to keep your credentials current.

Don’t wait until an emergency happens to wish you were prepared. Contact CPR Kansas City today to enroll in a class and gain the confidence and competence to save a life. Visit our website or call us to find a course that fits your schedule. Your training could make all the difference for someone in need.